Jaycox Lisa H, Stein Bradley D, Paddock Susan, Miles Jeremy N V, Chandra Anita, Meredith Lisa S, Tanielian Terri, Hickey Scot, Burnam M Audrey
Department of Health, Rand Corp, Arlington, Virginia 22202, USA.
Pediatrics. 2009 Oct;124(4):e596-605. doi: 10.1542/peds.2008-3348. Epub 2009 Sep 7.
This study aimed to determine the impact of teen depression on peer, family, school, and physical functioning and the burden on parents.
Patients participated in a longitudinal study of teens with and without probable depression, drawn from 11 primary care offices in Los Angeles, California, and Washington, DC. A total of 4856 teens completed full screening assessments; 4713 were eligible for the study, and 187 (4.0%) met the criteria for probable depression and were invited to participate, as were teens who were not depressed. A total of 184 baseline assessments for teens with probable depression and 184 for nondepressed teens were completed, as were 339 (90%) parent interviews. Follow-up interviews were conducted with 328 teens (89%) and 302 parents (82%). Measures included teen reports of peer and parent support, 2 measures of school functioning, grades, physical health, and days of impairment. Parent reports included peer, school, and family functioning and subjective and objective burdens on parents.
Teens with depression and their parents reported more impairment in all areas, compared with teens without depression at baseline, and reported more coexisting emotional and behavioral problems. Both depression and coexisting problems were related to impairment. There was a lasting impact of depressive symptoms on most measures of peer, family, and school functioning 6 months later, but controlling for coexisting baseline emotional and behavioral problems attenuated this relationship for some measures.
Improvements in teen depression might have benefits that extend beyond clinical symptoms, improving peer, family, and school functioning over time.
本研究旨在确定青少年抑郁症对同伴、家庭、学校和身体功能的影响以及对父母的负担。
患者参与了一项对有或无可能患抑郁症青少年的纵向研究，这些青少年来自加利福尼亚州洛杉矶和华盛顿特区的11个初级保健机构。共有4856名青少年完成了全面筛查评估；4713名符合研究条件，187名（4.0%）符合可能患抑郁症的标准并被邀请参与，未患抑郁症的青少年也被邀请参与。共完成了184名可能患抑郁症青少年的基线评估和184名未患抑郁症青少年的基线评估，以及339次（90%）家长访谈。对328名青少年（89%）和302名家长（82%）进行了随访访谈。测量指标包括青少年报告的同伴和家长支持、学校功能的两项测量指标、成绩、身体健康和受损天数。家长报告包括同伴、学校和家庭功能以及家长的主观和客观负担。
与基线时未患抑郁症的青少年相比，患抑郁症的青少年及其父母报告在所有领域的受损情况更多，并且报告有更多并存的情绪和行为问题。抑郁症和并存问题均与受损情况相关。6个月后，抑郁症状对同伴、家庭和学校功能的大多数测量指标都有持久影响，但在控制并存的基线情绪和行为问题后，某些测量指标的这种关系有所减弱。
青少年抑郁症的改善可能带来超出临床症状的益处，随着时间推移改善同伴、家庭和学校功能。
